How
do I select a surgeon?
It
is important to find a surgeon who takes time to talk to you and after a
thorough evaluation discusses all of your treatment options. It's
difficult to evaluate surgical skills without talking to medical personnel
who observe surgery, but you can get some idea of someone's comfort
level with a procedure by talking to them. While it's
important to understand that there are risks to any surgery, I would
steer away from anyone who states that myomectomy is too difficult to
do, bleeds too much, or if they do not seem comfortable with the
procedure. While there is no fixed number of cases required to
gain the necessary skill, you want to be sure that you have someone who
does more than an occasional myomectomy, and who has the expertise and
determination to complete the procedure.
Are
fibroids cancerous?
Fibroids
are benign tumors. This risk of cancer in a fibroid is estimated
to be less than 1 in 500. There is no evidence that benign
fibroids will become cancerous.
Will
my fibroids grow back?
Once
fibroids are removed those particular fibroids cannot grow back.
But fibroids are caused by genetic mutations within uterine muscle
cells. This process can over time create new fibroids. In
addition, there can be tiny fibroids that cannot be seen or felt, and
therefore cannot be removed. This is most likely to happen in
someone who has many little fibroids. Recurrence is least likely
in women with one or a few large fibroids than with multiple small ones.
What
can you tell me about shrinking fibroids with Depo-Lupron®.
Depo-Lupron®
is a medication that induces temporary menopause. This causes
modest and temporary shrinkage of fibroids. It is not a long term
solution, but is used at times prior to surgery. I offer it for
large fibroids if I feel it will allow a substantially smaller
incision. Most women have annoying but tolerable side effects such
as hot flashes. Disadvantages of Depo-Lupron®
include the possibility that it may make small fibroids more difficult
to find so that they are more likely to be left behind, and that at
times it can make it more difficult to separate the fibroids from the
wall of the uterus. I will recommend its use occasionally for very
large fibroids, but in most cases see no advantage to its use.
I
will be adding FAQ's as they come in, so keep watching this spot
—PDI
©2006, Paul Indman, MD. All Rights Reserved
15195 National Avenue, Suite 201; Los Gatos, CA 95032
Telephone : 408 358-2788 ; FAX : 408 356-5526
The
medical information presented in this website represents the opinion of Dr.
Indman, and is based on his knowledge and experience. It is not
applicable to all patients or physicians. Anyone visiting this or other
related medical sites should discuss symptoms, findings, and alternatives with
their personal gynecologist.
